Survival in Acute Myocardial Infarction Before and After the Establishment of a Coronary Care Unit

Abstract

The therapeutic results in acute myocardial infarction for two periods immediately preceding (pre-CCU) and after (post-CCU) establishment of a coronary care unit were compared. One hundred cases of proved myocardial infarction were selected at random from each time period. The coronary care unit reduced gross mortality from 33 percent (pre-CCU) to 16 percent (post-CCU). The reduction in mortality was most striking in the infero-lateral infarct, 33 percent to 11 percent. Anteroseptal infarction mortality was reduced from 33 percent to 21 percent. The major reduction in mortality in the post-CCU series occurred in the first six days. The arrhythmias observed more frequently in the post-CCU series were ventricular etopic beats, ventricular tachycardia, and complete heart block. Other arrhythmias were noted with equal frequency in both series. Sinus tachycardia and supraventricular tachycardias were associated with a high mortality rate in both groups. Ventricular tachycardia had a better prognosis than sinus tachycardia in the monitored series. In both groups, arrhythmias presenting after the first 72 hours were associated with a higher mortality.